This paper reviews the relevant pediatric literature about blood pressure (BP) hyperreactivity to stress as a possible precursor of hypertension and coronary heart disease. Two prospective studies of children indicate that BP hyperreactivity predicts later development of hypertension. Several studies have identified correlates of BP reactivity. Race, obesity, Type A and family history of hypertension appear to be associated with BP reactivity in children. There appear to be both genetic and environmental influences, but relatively few psychosocial variables have been studied. There are significant methodological concerns in terms of defining the characteristics of the stressors and the stability and generalizability of responses to laboratory stressors. BP reactivity in children is a potentially important area of inquiry that has been understudied.
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